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Behavioral Health & Social Service Providers Counselor Mental Health

Provider NPI: 1427462951

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
1601 E 4TH PLAIN BLVD BLDG 17 STE B222 VANCOUVER, WA 98661-3753 US
Tel: 360-397-8484  Fax: 360-397-8494

Business Mailing Address:
PO BOX 1845  VANCOUVER, WA 98668-1845 US
Tel: 360-397-8484  Fax: 360-697-8494

NPI Information:
NPI: 1427462951
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Mental Health

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YM0800X





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